There has been limited progress in the development of effective pharmacotherapy for sleep apnea. A range of agents has been utilized, but there has been lack of or only modest benefit in the treatment of OSA and CSA using these agents. A number of drug therapies are limited as well by significant side effects. The promise of serotonergic drug therapy is yet to be realized, and further developments await the full exploration and understanding of the complex interplay of the various and often counteractive 5-HT receptor subtypes in the CNS and PNS that in concert may affect upper airway patency in sleep and wake states. It is possible that effective OSA drug treatment may necessitate combination drug therapies, for example so that excitatory stimulation of upper airway dilator muscles in sleep is combined with pharmacological inhibitory actions on constrictor/relaxant mechanisms.
Given the lack of acceptance of CPAP in mild to moderate cases of OSA, better understanding of the neuropharmacology of OSA and potential pharmacotherapies is imperative.
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Clinical Pharmacology of Sleep
Edited by S.R. Pandi-Perumal and J.M. Monti
“2006 Birkh ¨auser Verlag/Switzerland